半球间裂胼胝体入路治疗重症丘脑出血的临床研究

Clinical Study on Hemispherical Corpus Callosum Approach for Severe Thalamic Hemorrhage

目的探讨半球间裂胼胝体入路治疗重症丘脑出血的临床效果。方法选择2013年2月—2018年12月期间收治的符合研究标准的46例重症丘脑出血患者,按照随机数字表法分为观察组(23例)与对照组(23例)。对照组采取传统手术方法进行治疗,观察组采取半球间裂胼胝体入路法治疗。观察并分析两组患者的手术时间、引流管留置时间、意识障碍恢复所需时间,比较术后日常生活能力评分(ADL)与格拉斯哥预后评分(GOS评分)情况,并比较两组术后并发症情况及临床总有效率。结果治疗后,与对照组比较,观察组患者手术时间、引流管留置时间、意识障碍恢复所需时间均降低显著(P<0.05);治疗后两组患者ADL评分与GOS评分情况改善明显,且观察组评分改善情况优于对照组,差异有统计学意义(P<0.05);经统计分析,观察组患者的并发症发生情况低于对照组,且临床总有效率(86.96%)也明显高于对照组(56.52%),差异有统计学意义(P<0.05)。结论重症丘脑出血患者采用半球间裂胼胝体入路法进行治疗,临床疗效确切,创伤微小,血肿清除彻底,术后神经功能恢复情况优良,安全系数高,值得在临床工作中推广应用。

Objective To investigate the clinical effect of interhemispheric sacral approach for severe thalamic hemorrhage.Methods Forty-six patients with severe thalamic hemorrhage who met the study criteria were enrolled in our hospital from February 2013 to December 2018.The above patients were divided into observation group(n=23)and control group(n=23)with the random number table method.The control group was treated with conventional surgery,and the observation group with hemispherical sacral approach.The operation time,drainage tube indwelling time,and time to recovery of consciousness disorder were observed and analyzed.The postoperative daily life ability score(ADL)and Glasgow prognosis score(GOS score)were compared and the postoperative complications were compared between the two groups.Also,the complications and clinical total effective rate were compared between the two groups.Results After treatment,compared with the control group,the operation time,drainage tube indwelling time,and recovery time of consciousness disorder were significantly decreased in the observation group(P<0.05).Besides,the ADL score and GOS score of the two groups were improved significantly.The improvement of the observation group score was significantly better than that of the control group(P<0.05).After statistical analysis,the complication of the observation group was lower than that of the control group,and the total clinical effective rate(86.96%)was also obvious.Compared with the control group(56.52%),the difference was statistically significant(P<0.05).Conclusion Patients with severe thalamic hemorrhage are treated with hemispherical sacral approach.The clinical effect is exact,the trauma is small,the hematoma is completely removed,the postoperative neurological function is excellent,and the safety factor is high.It is worthy of popularization and application in clinical practice.